Medication and long-distance cycling: post 600 thoughts

Henri Desgrange rides a Brevet Randonneur

I have written a lot about doping here, especially in relation to competitive cycling. Since I do not race, this is fairly neutral territory, and I can at least maintain a degree of objectivity. Recent discussion of the use of strong pain killers such as Tramadol, and of medical interventions for asthma and other respiratory issue in professional cycling, and my recent encounter with pain and injury has brought this all a little closer to home. Any medication can enhance performance, and the ethical issues here are complex: many athletes could not compete at all without asthma medication, and there are many situations where anti-inflammatory medication or an analgesic would be perfectly reasonable to enable someone to continue with a minor injury. I would suggest that there are three issues that limit such medical intervention in competition, notwithstanding chronic conditions which require maintenance:

the injury or condition should not be made worse by the use of medication;

the medication should not enhance the athlete’s performance above their baseline without such medication; and

the medication should be within the rules of the sport.

The reality and management of the boundaries between legal, ethical, medical and pragmatic aspects of medication during competitive exercise is in fact exceptionally complex (see this rather good article by Shane Stokes, for example). For non-competitive cycling similar boundaries might reasonably exist but performance enhancement becomes less of a legal issue and more of an ethical one. There are two very interesting pieces of writing on this, rather different in approach and the conclusions drawn, but both written by riders who have completed the Paris-Brest-Paris 1200km Randonnée. I will refer to both and then provide some personal context in the form of my experience of riding my first 600km Brevet, which I wrote about in my last blog entry here.

The first piece is from the magazine Outside Online in 2003, and is written by Stuart Stevens, who set out to experience for himself the impact of doping on his training and performance, culminating in the 2003 edition of PBP, which I intend to enter and complete in 2015 (it runs every four years). Here is what he says about his motivation and plan:

It was maddening to see skiers I knew to be playing fair, guys who trained their hearts out with little financial reward, lose to the cheaters. Over the years, it only got worse, the drugs more potent, the means of evading detection increasingly devious. Every time one of my athletic heroes tested positive, I was furious, as if I’d been personally betrayed.

But there was another feeling, too: deep curiosity. I’d read reams about cheating as an issue, but I’d never read anything describing what it felt like to do it. Obviously, the allure of victory was incredibly powerful—why else would the best athletes in the world risk their health and lives abusing these drugs? So I wondered, Do performance drugs make you just 1 percent faster and stronger? Or 10 percent? Are the enhancements so subtle that only elite athletes gain an edge, or are they powerful enough that an everyday wannabe like me would notice a dramatic change?

Though I knew I would be courting health risks, I decided there was only one way to find out: try it myself, and see what it did.

My plan was simple. I would train as I always do—about 15 to 20 hours a week—while taking various supplements under Dr. Jones’s supervision. I started in January 2003. In eight months, I intended to ride the 1,225-kilometer (761-mile) Paris-Brest-Paris bicycle race, a once-every-four-years sufferfest that’s popular among amateur ultracyclists. I would first have to qualify by completing a series of 200-, 300-, 400-, and 600-kilometer rides within certain time limits. The PBP was a quirky event, a ride rather than a real race, with no prizes, no ranking of finishers, no doping controls. So if the drugs helped me, I wouldn’t be knocking anybody else down in the standings. And since this was a monster ride—which I’d have to complete in less than 84 hours—it would serve as a real test of my augmented self.

The main thing Stevens learnt was that it is tiresome taking drugs, despite their apparent positive effects:

I felt shockingly strong until the final 200 kilometers, when my stomach started to shut down. Unaccustomed to the aero bars on the tandem, I’d also developed agonizing saddle sores. These were typical woes of ultrariding, but through it all, my legs and heart felt fine. Five months earlier, I couldn’t have imagined riding this far and feeling so strong. We finished the 1,225-kilometer ride in just under 76 hours—sleeping only twice for a few hours. The next morning, if it weren’t for my saddle sores, I could have easily done it again. Obviously, Dr. Jones’s program had worked.

I’d started months earlier with the goal of using the performance enhancers to complete the PBP. Now that it was over, I was relieved. When I got back from France, I immediately quit everything: no HGH, no testosterone, no EPO, and, God knows, no steroids. It was wonderfully liberating to be freed from a routine that had started out feeling illicit and interesting but had become just an annoying daily chore, like taking vitamins.

If the first piece is an extreme example of participant observer ethnography, which pulls no punches and is one of the best pieces on the experience of doping I have read (whatever you think of its ethical basis), the second piece is a typically well-thought out essay written from the outside of performance enhancement looking in. Jan Heine, who writes about and promotes an idiosyncratic but extremely influential Francophile view of cycling, and has finished PBP both as a solo and tandem rider (with very good times) writes:

With the recent news that Lance Armstrong effectively admitted to a large-scale doping conspiracy on his teams, the issue of doping has been front and center in the cycling news. A few readers have asked whether doping exists in randonneuring, too.

The short answer is yes – doping exists in any sport. A random test during a French cyclosportive (a timed long-distance ride) found astonishing numbers of riders with forbidden substances in their urine and bloodstream. Interestingly, it was not so much the faster riders who resorted to doping, but those who really wanted to beat 10 or 12 hours for a 200 km event.

He goes on to suggest that many past riders of PBP have used stimulants, but that they are probably unnecessary, and necessitated by belief, rather than actual effectiveness. He concludes that there are more important things to consider if you want to ride fast over long distances:

What about lead groups in recent PBPs? Having ridden with them for hundreds of kilometers in 2007, I was surprised that their pace was not as fast as that of typical racers. When we approached the first control, everybody was jockeying for position on the last climb, knowing that only the first riders would get through the control without delay. It was not difficult for me to maintain a position in the top five of the group. My conclusion was that you don’t need to resort to doping to stay with the lead group. More important is an efficient support team and consistency – I lost significant time and had to chase hard because I had to get my own water at the control. On the road, it appears that riders get dropped not because they aren’t fast enough, but because they suffer from a weak moment or two.

For everybody else, a fast time in a brevet mostly depends on managing your off-the-bike time well. No amount of doping will make you faster at the controls. So yes, it is likely that there is doping in randonneuring – as there is abuse of medication in all parts of society. But unlike in professional bike racing, doping is not a prerequisite for success in randonneuring, however one chooses to define that success.

Of course, speed is a bit of a red herring when one considers why a randonneur might excessively medicate. The use of anti-inflammatories and analgesics either after the event, or to deal with an injury that occurs during the ride would be a more common and seemingly sensible practice, unless it exacerbates an injury. However, I have witnessed prophylactic use of ibuprofen on brevet rides, and although I have absolutely no problem with this ethically (although I would not do it myself) I would question its wisdom on health grounds. And using stimulants to keep awake, as any WWII bomber pilot would tell you, only lasts up to a point – eventually impairments of judgement or a crash will result!

I finished my first 600km Brevet on two cups of sugary tea (the only caffeine I ingested), water, caffeine-free sports drinks, gels and energy bars; I may have had a can of coke, but I’m pretty sure I didn’t. Real food: cheese sandwiches, fish and chips with mushy peas, flavoured milk… and a vegetable samosa. After the ride, I took some ibuprofen to calm the inflammation affecting my shoulders and hands, but not for long, because it makes me feel vile. I am still in pain four days after finishing, and suffering from altered sensation in both hands, although I am now much improved. It may be that my approach is unnecessarily puritan, or not puritan enough (get rid of the space food) but it wasn’t really considered: like the lovely guy riding a Pashley roadster I just did my own thing. You may choose a different path…

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Did you meet Sir Wobbly (https://twitter.com/SirWobbly) on the Pashley? If so, how cool! Congratulations on completing the ride. I also do some randonneuring and have found that real food that is easily digestible works better for me in the long run than protein drinks, energy bars, and gels (though they can do the trick in a pinch). In addition, I have found continuing to eat well and rest after the event really help aid recovery. All the best in your PBP pursuits!